Pregnancy outcomes in HIV-infected women receiving long-term isoniazid prophylaxis for tuberculosis and antiretroviral therapy.
Pregnancy outcomes in HIV-infected women receiving long-term isoniazid prophylaxis for tuberculosis and antiretroviral therapy.
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DOI：
10.1155/2013/195637
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发表时间：
2013
影响因子：
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通讯作者：
Samandari T
中科院分区：
文献类型：
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作者：
Taylor AW;Mosimaneotsile B;Mathebula U;Mathoma A;Moathlodi R;Theebetsile I;Samandari T
目标。虽然6至12个月的异烟肼预防结核病疗程被认为对孕妇是安全的，但长期异烟肼预防或异烟肼联合抗逆转录病毒治疗（ART）对治疗期间怀孕的人类免疫缺陷病毒（HIV）感染妇女的影响尚未确定。设计。参与安慰剂对照的艾滋病毒感染妇女妊娠结局的巢式研究，结核病预防试验使用36个月每日异烟肼。通过访谈和记录回顾收集妊娠结局。结果。196例孕妇中，103例（52.6%）在妊娠期间暴露于异烟肼；所有人都接触了抗逆转录病毒药物。怀孕前，她们接受异烟肼治疗的中位数为341天（范围1-1095天）。我们在103名妇女中未观察到异烟肼相关肝炎或其他严重的异烟肼相关不良事件。妊娠结局为132例足月活产、42例早产、11例死产、8例低出生体重、6例自然流产、4例新生儿死亡和1例先天性异常。在多变量模型中，妊娠期间异烟肼和抗逆转录病毒药物暴露与不良妊娠结局均无显著相关性（校正优势比为0.6,95% CI为0.3-1.1和1.8,95% CI为0.9-3.6）。结论。长期异烟肼预防与不良妊娠结局（如早产）无关，即使在ART暴露的情况下也是如此。
Objective. While 6- to 12-month courses of isoniazid for tuberculosis prevention are considered safe in pregnant women, the effects of longer-term isoniazid prophylaxis or isoniazid in combination with antiretroviral therapy (ART) are not established in human-immunodeficiency-virus-(HIV-) infected women who experience pregnancy during the course of therapy. Design. Nested study of pregnancy outcomes among HIV-infected women participating in a placebo-controlled, TB-prevention trial using 36 months daily isoniazid. Pregnancy outcomes were collected by interview and record review. Results. Among 196 pregnant women, 103 (52.6%) were exposed to isoniazid during pregnancy; all were exposed to antiretroviral drugs. Prior to pregnancy they had received a median of 341 days (range 1–1095) of isoniazid. We observed no isoniazid-associated hepatitis or other severe isoniazid-associated adverse events in the 103 women. Pregnancy outcomes were 132 term live births, 42 premature births, 11 stillbirths, 8 low birth weight, 6 spontaneous abortions, 4 neonatal deaths, and 1 congenital abnormality. In a multivariable model, neither isoniazid nor ART exposure during pregnancy was significantly associated with adverse pregnancy outcome (adjusted odds ratios 0.6, 95% CI: 0.3–1.1 and 1.8, 95% CI 0.9–3.6, resp.). Conclusions. Long-term isoniazid prophylaxis was not associated with adverse pregnancy outcomes, such as preterm delivery, even in the context of ART exposure.